11 Possible Causes Of Epigastric Pain

Feature | man having acid reflux | Possible Causes of Epigastric Pain
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Epigastric pain, from time to time, shouldn’t be a cause for alarm as this might just be because of eating bad food, but there are digestive diseases linked with this discomfort.
RELATED: Top 5 Gut Healing Foods (And Why Bone Broth Is Not On This List)
In this article:

  1. Acid Reflux or Gastroesophageal Reflux Disease (GERD)
  2. Indigestion
  3. Overeating
  4. Lactose Intolerance
  5. Drinking Alcohol
  6. Esophagitis
  7. Gastritis
  8. Hiatal Hernia
  9. Peptic Ulcer
  10. Barrett’s Esophagus
  11. Gallstones

11 Potential Causes of Epigastric Pain

What Is Epigastric Pain?

Epi in the term epigastric pain is a Greek prefix meaning upper or over. Epigastric pain, then, is the discomfort felt in the middle of the upper abdomen below the ribcage.

1. Acid Reflux or Gastroesophageal Reflux Disease (GERD)

When some of the acid or the food in your stomach flows back up into your esophagus, you will experience acid reflux. This causes pain in the chest and throat.
Our stomachs contain hydrochloric acid—a strong kind of acid—that helps in breaking down food and protecting us from bacteria. The stomach is made to withstand this acid while the esophagus isn’t, hence the pain.
Constant acid reflux may mean the existence of gastroesophageal reflux disease (GERD). It is due to the malfunctioning of the gastroesophageal sphincter, a ring of muscle that acts as a valve that seals the stomach to prevent its contents from moving back up.
The epigastric pain caused by acid reflux may be accompanied by the following symptoms:

  • heartburn
  • indigestion
  • abnormal acidic taste in your mouth
  • throat soreness or hoarseness
  • feeling a lump in your throat
  • ongoing cough

2. Indigestion

woman stomach pain | Possible Causes of Epigastric Pain
After eating a meal, the stomach produces acid to break the food down. When it is unable to, stomach pain resulting from indigestion happens.
This epigastric pain after eating may specifically be caused by the acid irritating and/or inflaming the protective lining of the digestive system. It can manifest with:

  • dyspepsia or the pain in the upper abdomen;
  • heartburn, a burning sensation behind the breastbone;
  • or both, simultaneously.

Inflammation in the digestive system does not happen in the majority of indigestion patients. In these cases, the symptoms are thought to be brought by increased sensitivity of the lining to either acidity or stretching.
Other symptoms of indigestion that are commonly felt together with epigastric pain are:

  • burping
  • bloating in the abdomen
  • feeling full or bloated, even if the portion size was not big
  • nausea

3. Overeating

Eating too much will cause the stomach to expand beyond its normal size. As a result, the enlarged stomach puts a lot of pressure on the surrounding organs.
This pressure can induce abdominal pain and breathing difficulty as the lungs will have lesser room to expand to when exhaling.
Additionally, as mentioned earlier, the acid produced by the stomach to break down food can travel back to the esophagus causing acid reflux and heartburn. These can worsen the epigastric pain.
For patients with eating disorders that involves binge and overeating, repeated vomiting after eating can lead to epigastric pain, too.

4. Lactose Intolerance

woman sitting on toilet | Possible Causes of Epigastric Pain
When you lack sufficient lactase in your system—the enzyme responsible for breaking down lactose—you develop lactose intolerance. As a result, your body will find it hard to digest lactose-rich foods like dairy products.
If you’re lactose intolerant, consuming dairy may cause epigastric pain with the following symptoms:

  • feeling bloated
  • diarrhea
  • nausea
  • vomiting

5. Drinking Alcohol

Occasional, moderate drinking won’t harm the stomach. But, drinking too much at once, or excessive drinking over time can cause the inflammation of the stomach lining.
This inflammation can cause epigastric pain.

6. Esophagitis

female holding her neck | Possible Causes of Epigastric Pain
Esophagitis occurs when the esophagus or food pipe gets inflamed. The common causes for this condition are acid reflux, infection, allergies, and medication-induced chronic irritation.
The inflammation, together with the symptoms of the causative illness, triggers epigastric pain.
RELATED: Interventional Pain Management: A Comprehensive Approach To Chronic Pain

7. Gastritis

Gastritis is the inflammation of the stomach lining or mucosa. It can be caused by bacterial infection, preexisting damage in the stomach, or an immune system disorder.
Regular intake of certain pain killers and too much alcohol can also contribute to gastritis.
The resulting epigastric pain may come with the other symptoms of gastritis:

  • pain or discomfort in the upper body or chest
  • nausea
  • coffee ground (blood) vomit
  • black stool

8. Hiatal Hernia

man having chest pain | Possible Causes of Epigastric Pain
The hiatus is the small opening in the diaphragm through which the esophagus passes to connect to the stomach. When the stomach pushes up through that opening and into the chest, hiatal hernia happens.
Small hiatal hernias do not usually cause any problem. In fact, you may never even know you have one unless discovered by your physician when checking for other conditions.
But larger hiatal hernias can cause heartburn as food and acid can move back up the esophagus. Aside from epigastric pain, symptoms may also include:

  • sore throat
  • irritation or scratchiness in the throat
  • trouble swallowing
  • gas or especially loud burps
  • chest discomfort

9. Peptic Ulcer

Peptic ulcers occur when the lining of the small intestine or stomach are damaged by excessive nonsteroidal anti-inflammatory drug (NSAIDs) intake or by bacterial infections.
These damages are often in the form of open sores. When acid touches the sores, epigastric pain occurs.

10. Barrett’s Esophagus

man painful throat | Possible Causes of Epigastric Pain
Barrett’s esophagus (AKA intestinal metaplasia) is a condition where the tissue lining of the esophagus becomes more like the intestinal lining. It is often discovered in people suffering from long-term GERD.
Metaplasia Definition: This is the abnormal change in the nature of tissue.
This condition does not have defining symptoms of its own. It generally shares the same symptoms with GERD including upper abdominal pain.

11. Gallstones

Epigastric pain may occur in the presence of gallstones in the gallbladder. They inflame the tissues and block the opening.
The intense epigastric pain comes from the upper right side, where the gallbladder is located. Jaundice or yellowing of the skin and clay-colored stools are accompanying symptoms.
Here is a quick video from Gesundheitsinformation about the causes of epigastric pain:
Occasional stomach pains are usually nothing serious. But, if you are experiencing persistent or severe epigastric pain, immediately seek professional help.
Identifying the cause of the pain is the smartest first step you can do towards epigastric pain treatment. Early diagnosis and prevention are of utmost importance.
Do you have any other questions about epigastric pain? Let us know in the comments section below!
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